Reasons for the Complex Diagnosis of Basilar Artery Occlusions: Russell Cerejo, MD


The vascular neurologist at Allegheny Health Network provided perspective on the complex diagnosis of basilar artery occlusions and the signs clinicians and emergency room specialists should be aware of. [WATCH TIME: 2 minutes]

WATCH TIME: 2 minutes

"People may not be aware of that, and they might not seek medical care. By the time they seek medical care, or we realize what’s going on, it may be too late and we will not be able to help them."

While posterior circulation strokes account for about 15% to 20% of all ischemic strokes, basilar artery occlusion (BAO), a potentially fatal diagnosis, is a subset of this category, representing 1% to 4% of all ischemic strokes. It has been frequently reported that diagnosing a BAO syndrome can be difficult for family, first responders, and physicians, and the follow-up treatment decisions are not easy as well. Some in the field, including Russell Cerejo, MD, point to a lack of consensus guidelines, as well as the general complexity of BAOs.

Relative to anterior circulation stroke syndromes, posterior circulation ischemic may have longer prodrome and an evolution that is important to recognize. Between first prodromal symptoms and stroke onset, the latency can be anywhere from days to months and may increase in frequency as the stroke approaches. Cerejo, a vascular neurologist at Allegheny Health Network, recently sat down to discuss the challenges with diagnosing BAOs, and the symptoms neurologists and emergency department workers should be aware of. Additionally, he touched upon how recent changes to the acronym BE-FAST, a tool used to educate the public on the early signs of stroke, have helped with the detection and diagnosis of BAOs.

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